Colon cancer is a frightening word for anyone to hear. For those who have been diagnosed with it or are at risk of developing it, that fear can be all-consuming. This type of cancer is also relatively common. In fact, between 2017 and 2021, colorectal cancer was among the top three most commonly diagnosed cancers in both males and females in Singapore. It also ranked as one of the leading causes of cancer-related deaths during the same period, as reported by the Singapore Cancer Registry Annual Report 2021.

However, colon cancer can be treated effectively if caught early. Therefore, being aware of the risk factors and making lifestyle changes can also reduce the chances of colon cancer. In this post, OncoCare, a leading colon cancer specialist in Singapore, discusses what colon cancer is, how to prevent it, the most common spread sites for colon cancer, and treatment methods.

What is Colon Cancer?

Colon cancer originates in the large intestine, which constitutes the final part of the digestive system. It usually starts as tiny, non-cancerous groups of cells called polyps that form on the inside wall of the colon. While these polyps are initially harmless and often present no symptoms, they can develop into colon cancer over time.

Most people who get colon cancer are older. Statistics from the Singapore Cancer Registry Annual Report 2021 illustrate its broad impact across various age ranges. For instance, among males aged 30 to 39, colorectal cancer was the second most common type, with 100 cases reported between 2017 and 2021. In contrast, for males aged 50 to 59, it was the most common, with 1,124 cases in the same period. Similarly, for women aged 40 to 49, it ranked as the fourth most common cancer with 340 cases, and for those aged 60 to 69, it escalated to the second most common with 1,517 cases.

However, despite this trend, colon cancer does not exclusively affect specific age groups. While it is more common in older adults, younger individuals can also develop colon cancer. In fact, according to HealthXchange, there has been a concerning rise in colon cancer cases among younger adults in recent years, with up to one-fifth of cases now occurring in this age group.

This is why doctors recommend regular screening tests to help prevent colon cancer by identifying and removing polyps before they develop into adenomatous polyps with dysplasia (precancerous & abnormal cells) that turn into cancer.

The Stages of Colon Cancer

Colon cancer develops in stages, reflecting the growth and spread of the disease within the body.

• Stage 0: During this stage, the cancer is confined to the inner layer of the colon or rectum.
• Stage I: Cancer has begun to grow deeper into the inner layer but has not spread beyond the colon or rectum wall.
• Stage II: At this stage, the cancer has extended through the wall of the colon or rectum but has not affected the lymph nodes.
• Stage III: Cancer has spread to nearby lymph nodes but may not have spread to other parts of the body.
• Stage IV: The most advanced stage, where the cancer has spread to other parts of the body.
• Recurrent: This refers to cancer that has returned after treatment, either in the same place or somewhere else in the body.

Frequent Spread Sites Of Colon Cancer

Colon cancer can spread to different parts of the body, but there are some areas where it is more likely to go. The most common spread sites are the liver and lungs, lymph nodes, bones (spine, hip, long bones such as legs or arms) and peritoneum (membrane that lines the abdominal cavity).

When colon cancer has spread to these respective areas, certain symptoms may emerge in those parts of the body:

• Liver: fatigue, jaundice, swelling in extremities, nausea or abdominal bloating
• Lungs: shortness of breath, difficulty breathing, chest pain or persistent cough
• Lymph nodes: abdominal bloating and swelling as well as a reduced appetite
• Peritoneum: abdominal pain, bloating, a constant feeling of fullness, weight gain or loss or nausea
• Bones: bone pain, bone weakness that can lead to breaks, high levels of calcium in your blood, spine compression

What Are Some of the Biggest Risk Factors for Colon Cancer?

As covered above, as you age, your risk for colon cancer goes up. Other risk factors of colorectal cancer include:

• Having family members who have had colon or rectum cancer such as familial adenomatous polyposis (FAP), hereditary nonpolyposis colon cancer (HNPCC))
• Eating a lot of meat (especially red and processed meat) along with insufficient consumption of fruits and vegetables
• A lack of exercise
• Being overweight
• Smoking
• Drinking a lot of alcohol
• Having certain medical conditions such as inflammatory bowel disease

What Are the Warning Signs of Colon Cancer?

Colon cancer symptoms can be hard to notice because they are non-specific. This means that they can be caused by other things besides cancer. However, some common symptoms of colon cancer are:

• Having abdominal pain or bloating more often than usual
• Disruption to your bowel habits, such as diarrhoea, constipation or alternating between both
• Blood in your stools, and/or
• Losing weight without meaning to
• Jaundice

What Should I Do If I Show Symptoms Of Colon Cancer?

Early detection of cancer is crucial to effective treatment. If you show signs of colon cancer, it is best to go for a screening with a colon cancer specialist in Singapore such as OncoCare.

There are a few options for screening such as:

• FOBT/Faecal Occult Blood Test – Testing the stools for blood that you may not be able to see with your eyes
• Colonoscopy – insertion of a flexible tube with a camera into the rectum & colon to take a closer look at the inside of the large intestines
• Computer Tomography (CT) Colonography or ‘Virtual Colonography’ – undergoing a scan of the intestines for a detailed examination of the inside of the large intestines

For an accurate diagnosis of suspected cancerous cells and tumours, you can also go for a biopsy, where a sample of your body’s cells or tissues will be taken to determine the presence or extent of cancer.

Is There a Way to Prevent Colon Cancer?

Understanding the risk factors that can cause colon cancer helps in knowing how to prevent it.

Regular Screenings:

• Colonoscopy: Utilises a flexible camera to inspect the entire colon and remove polyps during the procedure. Advised every decade starting at age 45, with the potential for earlier screenings depending on family risk factors.

• Home Stool Tests (FIT or FOBT): Straightforward tests exist to check for unseen traces of blood in your stool, which could signal potential cancer. These should ideally be conducted on a yearly basis.
• Additional Screening Options: Sigmoidoscopy and virtual colonoscopy are other reliable screening methods.

Lifestyle Adjustments:

• Maintain a Healthy Weight: Maintaining a healthy weight can play a role in cancer prevention, including reducing your chances of developing colon cancer.
• Quit Smoking: Quitting smoking is absolutely essential. Not only does it significantly lower your risk of colon cancer, but it also helps protect you from a number of other serious health problems.
• Physical Activity: Engaging in regular exercise such as walking, cycling, or dancing for about 30 minutes a day can significantly decrease cancer risk.
• Limit Alcohol Consumption: Reducing alcohol intake lowers the risk of colon and other cancers. Opting not to drink is the healthiest choice.
• Reduce Red and Processed Meat Consumption: Limit intake to less than three servings per week to decrease colon cancer risk.
• Increase Calcium and Vitamin D Intake: Aim for 1000 to 1200mg of calcium and about 1000 IU of vitamin D daily to protect against colon cancer.
• Consume More Whole Grains and Fibre: A diet high in whole grains and fibre aids in reducing colon cancer risk. Strive for at least three servings of whole grains and 22 to 34g of fibre daily.

OncoCare: Your Colon Cancer Specialist In Singapore

With colorectal cancer being the third most common cancer in the world for men and women, it is advisable to go to a colon cancer specialist in Singapore such as OncoCare for diagnosis and treatment if you have any of the symptoms mentioned above.

At OncoCare, we take a multi-disciplinary approach to colon cancer treatment. This means that we use a variety of different treatments such as chemotherapy, targeted therapy and immunotherapy for selected patients that best suit each individual’s needs and condition. Chemotherapy is designed to kill cancer cells, targeted therapy is designed to only kill certain malignant tumour cells, and immunotherapy is designed to harness the natural ability of our immune system to combat cancer.

Make an appointment at one of our clinics today to learn how we can assist you in your cancer journey. Alternatively, find out more about the different treatments, screenings and tests we use, and explore our services page.

“Expert knowledge means better care for cancer”

Written by:
Dr Akhil Chopra
MBBS (Delhi)
American Board Certified (Int Med)
American Board Certified (Hematology)
American Board Certified (Med Oncology)